MARY IMMACULATE HOSPITAL LLC (NPI# 1538535463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538535463 |
| Entity Type | Organization |
| Organization Name | MARY IMMACULATE HOSPITAL LLC |
| Other Organization Name | BON SECOURS MARY IMMACULATE HOSPITAL PRO FEE |
| Practice Address |
2 Bernardine Dr Newport News VA 23602-4404 |
| Mailing Address |
8580 Magellan Pkwy Richmond VA 23227-1149 |
| Practice Telephone | 7573982208 |
| Practice Fax Number | 7573982004 |
| Mailing Fax Number | 8664490896 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2020-09-21 |
| Authorized Official Name | WILBUR GAY (CFO) |
| Authorized Official Telephone | 8645617672 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARY IMMACULATE HOSPITAL LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| Bon Secours Mary Immaculate Hospital pro fee | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205142791 | Mary Immaculate Hospital LLC | Surgery | 12720 Mcmanus Blvd Ste 305, Newport News, VA 23602-4414 | 2010-08-23 |
| 1568612265 | Mary Immaculate Hospital LLC | Nurse Practitioner | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2008-09-30 |
| 1427064310 | Mary Immaculate Hospital LLC | General Acute Care Hospital | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2006-07-31 |
| Street Address |
2 BERNARDINE DR |
| City | NEWPORT NEWS |
| State | VA |
| Zip Code | 23602-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417955204 | Ruth H. Innes | Family Medicine | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2005-07-14 |
| 1194355214 | Eliezer Dulay Urbano | Clinical Nurse Specialist | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2020-01-16 |
| 1639631849 | Pamela Vancott | Pharmacist | 2 Bernardine Dr, Newport News, VA 23602-4499 | 2019-04-05 |
| 1487116455 | Katherine Nicole Hill Sheppard | Registered Nurse | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2019-04-01 |
| 1053825760 | Anna Marie Rhodes | Specialist/Technologist, Other | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2017-11-17 |
| 1023546256 | Samuel Kyle Holloway | Physician Assistant | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2017-06-01 |
| 1114470853 | Lauren N Sharpe-payne | Speech-Language Pathologist | 2 Bernardine Dr, Newport News, VA 23602 | 2016-07-29 |
| 1518344530 | Jason Bavarian | Emergency Medicine | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2015-04-28 |
| 1760878078 | Catherine Shany Agustiady-becker | Emergency Medicine | 2 Bernardine Dr, Newport News, VA 23602 | 2015-04-13 |
| 1326432899 | Lindsey Belk Williams | Anesthesiology | 2 Bernardine Dr, Newport News, VA 23602-4499 | 2015-03-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538789425 | Aishah Naomi Khursheed | Counselor | 727 J Clyde Blvd, Ste A, Newport News, VA 23602 | 2020-04-21 |
| 1962069526 | Boss Inner Child Counseling, LLC | Clinic/Center | 14203 Old Courthouse Way, Suite B, Newport News, VA 23602 | 2019-05-20 |
| 1922598572 | Manoj Chawla | Internal Medicine | 1000 Old Denbigh Blvd # 1020a, Newport News, VA 23602 | 2018-05-18 |
| 1750896999 | Alexandra Paige Jones | Behavioral Analyst | 12727 Mcmanus Blvd., Newport News, VA 23602 | 2017-12-11 |
| 1457712556 | Mary Ellen Lynch | Registered Nurse | American Addiction Treatment Center, 12695 Mcmanus Blvd, Bdg 2, Newport News, VA 23602 | 2016-03-16 |
| 1790159481 | Megan Ashley Burkart Schmidt | Registered Nurse | 903 Kinsale Cres, Newport News, VA 23602 | 2015-11-18 |
| 1962870733 | Natalie Marie Bradshaw-smith | Nurse Practitioner | 401 Oyster Point Rd Ste A, Newport News, VA 23602 | 2015-09-09 |
| 1477953578 | Jonathan Edwards | Pathology | Bon Secours Mary Immaculate Hospital, Pathology Dept, 2 Bernardine Dr, Newport News, VA 23602 | 2014-08-26 |
| 1588063663 | Cathy G Cooke | Psychologist | 12695 Mcmanus Blvd. Bldg #8, Newport News, VA 23602 | 2014-08-14 |
| 1538576764 | John Michael Sullivan | Psychologist | One Old Oyster Point Road, Newport News, VA 23602 | 2014-07-21 |
| Find all providers in zip 23602 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861779852 | Riverside Regional Medical Center | General Acute Care Hospital | 542 K Eleanor Court, Newport News, VA 23602 | 2011-11-04 |
| 1609162270 | Riverside Medical Education | General Acute Care Hospital | 12200 Warwick Blvd Ste 490a, Newport News, VA 23601-2548 | 2011-06-22 |
| 1679979744 | Riverside Hospital, Inc | General Acute Care Hospital | 12100 Warwick Blvd, Suite 210b, Newport News, VA 23601-2365 | 2014-11-17 |
| 1356543995 | Riverside Regional Medical Center | General Acute Care Hospital | 500 J Clyde Morris Blvd, Department of Medical Education - Family Medicine, Newport News, VA 23601-1929 | 2007-06-05 |
| 1700088721 | Riverside Regional Medical Center | General Acute Care Hospital | 500 J Clyde Morris Blvd, Newport News, VA 23601-1929 | 2007-06-01 |
| 1366547747 | Riverside Hospital Inc | General Acute Care Hospital | 500 J Clyde Morris Blvd, Newport News, VA 23601 | 2006-09-13 |
| 1427064310 | Mary Immaculate Hospital LLC | General Acute Care Hospital | 2 Bernardine Dr, Newport News, VA 23602-4404 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538669445 | Virginia Hospital Center Arlington Health System | General Acute Care Hospital | 8100 Boone Blvd Ste 140, Vienna, VA 22182-2665 | 2018-02-16 |
| 1871020651 | Virginia Internal Medicine Specialists LLC | General Acute Care Hospital | 44790 Maynard Sq Ste 320, Ashburn, VA 20147-6514 | 2017-05-11 |
| 1730615816 | Sentara Healthcare | General Acute Care Hospital | 100 Ireland St, Hampton, VA 23663-2150 | 2017-05-10 |
| 1528592573 | New York Presbyterian Hospital-weill Cornell | General Acute Care Hospital | 9644 Sutton Green Ct, Vienna, VA 22181-6105 | 2017-04-17 |
| 1386181733 | Lyle Purnell | General Acute Care Hospital | 100 Emancipation Dr Bldg 146, Hampton, VA 23667-0001 | 2017-01-24 |
| 1700233855 | Debra Hafer | General Acute Care Hospital | 33290 Chincoteague Rd, Wallops Island, VA 23337-2204 | 2016-05-18 |
| 1093161374 | Mawussi Komi | General Acute Care Hospital | 6271 Drew Dr, Va Beach, VA 23464 | 2016-05-05 |
| 1700248796 | Hq Surgical | General Acute Care Hospital | 905 Hathaway Ct, Chesapeake, VA 23322-7622 | 2016-03-28 |
| 1710355649 | Johnston Memorial Hospital, Inc | General Acute Care Hospital | 3175 Linden Dr Ste 3-5, Bristol, VA 24202-5849 | 2015-09-09 |
| 1184092298 | Anita Sites | General Acute Care Hospital | Uva Transplant Center 1300 Jefferson Park Ave Fl 4, Charlottesville, VA 22908-3363 | 2015-09-04 |
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| City | NEWPORT NEWS |
| Zip Code | 23602 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.